Pharmacologic Treatment Initiation Among Medicare Beneficiaries Hospitalized With Alcohol Use Disorder
Authors: Eden Y. Bernstein, Travis P. Baggett, Shrunjal Trivedi, Shoshana J. Herzig, Timothy S. Anderson
Journal: Annals of Internal Medicine (2023)

LettersAugust 2023Pharmacologic Treatment Initiation Among Medicare Beneficiaries Hospitalized With Alcohol Use DisorderCorrection(s) for this article:Corrections29 Aug 2023Correction: Pharmacologic Treatment Initiation Among Medicare Beneficiaries Hospitalized With Alcohol Use DisorderFREEEden Y. Bernstein, MD, Travis P. Baggett, MD, MPH, Shrunjal Trivedi, MPH, Shoshana J. Herzig, MD, MPH, Timothy S. Anderson, MD, MASEden Y. Bernstein, MDDivision of General Internal Medicine, Massachusetts General Hospital, and Harvard Medical School, Boston, Massachusetts, Travis P. Baggett, MD, MPHDivision of General Internal Medicine, Massachusetts General Hospital; Harvard Medical School; and Institute for Research, Quality, and Policy in Homeless Health Care, Boston Health Care for the Homeless Program, Boston, Massachusetts, Shrunjal Trivedi, MPHDivision of General Medicine, Beth Israel Deaconess Medical Center, Boston, Massachusetts, Shoshana J. Herzig, MD, MPHHarvard Medical School and Division of General Medicine, Beth Israel Deaconess Medical Center, Boston, Massachusetts, Timothy S. Anderson, MD, MASHarvard Medical School and Division of General Medicine, Beth Israel Deaconess Medical Center, Boston, MassachusettsAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/M23-0641 Annals Author Insight Video - Eden Y. Bernstein, MD In this video, Eden Y. Bernstein, MD, offers additional insight into the article, "Pharmacologic Treatment Initiation Among Medicare Beneficiaries Hospitalized With Alcohol Use Disorder." (Duration 2:36) SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Background: In the United States, 29 million adults have alcohol use disorder (AUD), and alcohol contributes to more than 140 000 deaths annually (1). Hospitalizations provide an opportunity to promote behavior change by initiating treatment with medications for AUD (MAUD), including naltrexone, acamprosate, and disulfiram, which have been approved by the U.S. Food and Drug Administration for decades (2). Low prescribing rates for hospitalized patients have been observed in single-center studies, but nationwide data on MAUD treatment initiation after hospitalization are lacking (3).Objective: To characterize MAUD treatment initiation after AUD hospitalizations using the 20% national sample of Medicare Part D ...References1. National Institute on Alcohol Abuse and Alcoholism. Alcohol facts and statistics. Accessed at www.niaaa.nih.gov/publications/brochures-and-fact-sheets/alcohol-facts-and-statistics on 3 August 2022. Google Scholar2. Reus VI, Fochtmann LJ, Bukstein O, et al. The American Psychiatric Association practice guideline for the pharmacological treatment of patients with alcohol use disorder. Am J Psychiatry. 2018;175:86-90. [PMID: 29301420] doi:10.1176/appi.ajp.2017.1750101 CrossrefMedlineGoogle Scholar3. Martin M, Clement J, Defries T, et al. Prevalence and characteristics of hospitalizations with unhealthy alcohol use in a safety-net hospital from 2016 to 2018. J Gen Intern Med. 2022;37:3211-3213. [PMID: 35060005] doi:10.1007/s11606-021-07357-5 CrossrefMedlineGoogle Scholar4. Kim HM, Smith EG, Stano CM, et al. Validation of key behaviourally based mental health diagnoses in administrative data: suicide attempt, alcohol abuse, illicit drug abuse and tobacco use. BMC Health Serv Res. 2012;12:18. [PMID: 22270080] doi:10.1186/1472-6963-12-18 CrossrefMedlineGoogle Scholar5. Bernstein E, Guo N, Goto T, et al. Characterizing the variation of alcohol cessation pharmacotherapy in primary care. J Gen Intern Med. 2021;36:1989-1996. [PMID: 33515195] doi:10.1007/s11606-020-06454-1 CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAuthors: Eden Y. Bernstein, MD; Travis P. Baggett, MD, MPH; Shrunjal Trivedi, MPH; Shoshana J. Herzig, MD, MPH; Timothy S. Anderson, MD, MASAffiliations: Division of General Internal Medicine, Massachusetts General Hospital, and Harvard Medical School, Boston, MassachusettsDivision of General Internal Medicine, Massachusetts General Hospital; Harvard Medical School; and Institute for Research, Quality, and Policy in Homeless Health Care, Boston Health Care for the Homeless Program, Boston, MassachusettsDivision of General Medicine, Beth Israel Deaconess Medical Center, Boston, MassachusettsHarvard Medical School and Division of General Medicine, Beth Israel Deaconess Medical Center, Boston, MassachusettsPresented as an oral abstract at the 2023 Society of General Internal Medicine Annual Meeting, Aurora, Colorado, 10–13 May 2023.See also: Editorial comment (page 1129).Note: Dr. Anderson had full access to all of the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis.Disclaimer: The research reported in this publication was supported by the Agency for Healthcare Research and Quality and the National Institute on Aging of the National Institutes of Health. The content is solely the responsibility of the authors and does not necessarily represent the official views of the Agency for Healthcare Research and Quality or the National Institutes of Health.Financial Support: Dr. Bernstein received funding support from an institutional National Research Service Award (T32HP32715) and by the Massachusetts General Hospital Division of General Internal Medicine. Dr. Herzig was supported by grant R01HS026215 from the Agency for Healthcare Research and Quality. Dr. Anderson was supported by grant K76AG074878 from the National Institute on Aging. Dr. Baggett is supported by the Massachusetts General Hospital Research Scholars program. The Agency for Healthcare Research and Quality and the National Institute on Aging had no role in the design or conduct of the study; collection, management, analysis, or interpretation of the data; preparation, review, or approval of the manuscript; or decision to submit the manuscript for publication.Disclosures: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M23-0641.Reproducible Research Statement: Study protocol and data set: Not available. Statistical code: Available from Dr. Bernstein (e-mail, Eybernstein@mgh.harvard.edu).Corresponding Author: Eden Y. Bernstein, MD, 100 Cambridge Street, 16th Floor, Boston, MA 02114; e-mail, Eybernstein@mgh.harvard.edu.Correction: This article was amended on 29 August 2023 to correct several of the patient counts presented in the Table. A correction has been published (doi: 10.7326/L23-0320).This article was published at Annals.org on 27 June 2023. PreviousarticleNextarticle Advertisement Annals Author Insight Video - Eden Y. Bernstein, MD In this video, Eden Y. Bernstein, MD, offers additional insight into the article, "Pharmacologic Treatment Initiation Among Medicare Beneficiaries Hospitalized With Alcohol Use Disorder." (Duration 2:36) FiguresReferencesRelatedDetailsSee AlsoTreatment of Alcohol Use Disorder in Hospitalized Patients: Some Sobering Findings Michael F. Mayo-Smith , David Lawrence Correction: Pharmacologic Treatment Initiation Among Medicare Beneficiaries Hospitalized With Alcohol Use Disorder Metrics Cited byCorrection: Pharmacologic Treatment Initiation Among Medicare Beneficiaries Hospitalized With Alcohol Use DisorderTreatment of Alcohol Use Disorder in Hospitalized Patients: Some Sobering FindingsMichael F. Mayo-Smith, MD, MPH, David Lawrence, MD August 2023Volume 176, Issue 8Page: 1137-1139KeywordsAlcoholismHospital medicineHospitalizationsInpatientsPsychiatry and mental health ePublished: 27 June 2023 Issue Published: August 2023 Copyright & PermissionsCopyright © 2023 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...